Provider Demographics
NPI:1790416386
Name:SUA, JORDAN (GC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:SUA
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 EATON RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-2062
Mailing Address - Country:US
Mailing Address - Phone:908-766-2800
Mailing Address - Fax:
Practice Address - Street 1:30 LAFAYETTE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4178
Practice Address - Country:US
Practice Address - Phone:908-766-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS